With its income from private patients approaching government limits, Moorfields is one of the foundation trusts hoping that the recently announced review will lead to relaxed rules. Jonathan Gornall reports

Dubai, sun baked second city of the oil fuelled United Arab Emirates, glitzy home to the world’s tallest building, largest shopping mall, and two gigantic manmade islands created in the shape of stylised palm trees, is an unlikely setting for an ideological battle over the future of the British National Health Service. It is certainly a long way from City Road, London, but here, on the 370 000 m2 campus that is the world’s first medical free-zone—a tax and customs duty-free oasis in which 100% foreign ownership is allowed—can be found a bustling branch of Moorfields Eye Hospital, the first such overseas outpost and example of an entrepreneurial spirit that, depending on viewpoint, could either rescue or ravage the NHS.

Many in the NHS are watching with interest to see how the pioneering Dubai venture pans out; two years in, it has yet to make a profit but is ahead of its business plan and on target to do so. Under current legislation, the success of such schemes is limited by the cap on the percentage of total income foundation trusts can earn from private patients, but last week the government committed to a rapid review of the law that could change the rules. If this happens others may be tempted to follow Moorfields’ lead.

The private charges cap was introduced in the 2003 Health and Social Care Bill to appease concerns that the introduction of foundation trusts would lead to a two tier NHS. The bill eventually squeezed into law by just 17 votes by limiting the amount of income a foundation trust could earn from private patients to …